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Biomedical subjects

J Goldberg

Publications and source records attributed to J Goldberg.

At least 235 records · Page 13Linked to original sources
PubMed1991

Validation of physiologic predictors of successful telescopic spectacle use in low vision.

A group of 32 patients with low vision who were considered clinically appropriate candidates for visual rehabilitation with telescopic spectacles were prospectively studied before the first attempted use of these visual aids. Laboratory measurements were made of: (1) rotational head stability in pitch and yaw during quiet standing; (2) sensitivity of visual acuity with telescopic spectacles to imposed yaw head motion; and (3) ocular stabilization reflexes during passive, whole-body rotation in the horizontal plane. Predicted likelihood of successful use of telescopic spectacles was prospectively computed for each patient using the measurement of head stability in the pitch axis and the sensitivity of visual acuity with telescopic spectacles to head motion using a previously described statistical method. Patients were then given telescopic spectacles, and functional success was evaluated in the field at least 6 weeks later by independent masked observers. Although corrected visual acuities did not differ in the 24 patients in whom rehabilitation was successful or in the 8 patients in whom it was not, successful patients had statistically significantly less (P less than 0.05) angular head instability in pitch and yaw, as well as less impairment of visual acuity with telescopic spectacles during head motion. This finding was confirmed in a more clinically homogeneous subgroup of 16 patients who had low vision due to maculopathy. Gains of the 0.1 Hz horizontal vestibulo-ocular reflex (VOR) and visual-vestibulo-ocular reflex (VVOR) with 4X telescopic spectacles did not differ between patients in whom rehabilitation was successful and those in whom it was not.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

A twin study of the effects of the Vietnam War on posttraumatic stress disorder.

This study evaluates the impact of military service during the Vietnam era (1965 to 1975) on posttraumatic stress disorder using a sample of 2092 male-male, monozygotic, veteran twin pairs. Data were collected in 1987 using mail and telephone interviews. In 715 monozygotic twin pairs who were discordant for military service in southeast Asia (SEA), posttraumatic stress disorder was found to be strongly associated with military service in SEA. The prevalence of posttraumatic stress disorder was 16.8% in twins who served in SEA compared with 5.0% in co-twins who did not serve in SEA. There was a ninefold increase in the prevalence of posttraumatic stress disorder (95% confidence interval, 4.8 to 17.6), comparing twins who experienced high levels of combat with their co-twin who did not serve in SEA. Our results demonstrate that nearly 15 years following the end of the Vietnam War, there remains a substantially increased prevalence of posttraumatic stress disorder among veterans who served in SEA.

Adult↗
PubMed1990

A simulation model for evaluating a set of emergency vehicle base locations: development, validation, and usage.

This paper describes our experiences in developing a simulation model for evaluating a set of emergency response vehicle base locations. The project was undertaken jointly by the University of Arizona and the Tucson Fire Department. The issues of model development, data collection, model validation, and experimentation are discussed. The critical nature of the problem and the clients' lack of experience with mathematical models, made model validation the major step in gaining user acceptance. We show that looking solely at standard performance statistics such as the calls successfully serviced, may lead to the acceptance of an invalid model. We also show that the high level of detail used in many simulation models for evaluating base locations is unnecessary in the current case. An analysis evaluating two alternative sets of locations for the Tucson system is discussed.

Ambulances↗
PubMed1990

Computer modeling of emergency medical system performance.

Emergency medical services (EMS) system managers face difficult problems when determining the need for system expansion and unit deployment. Information relevant to the decision is often limited and frequently not in a usable format. This lack of usable information often results in decisions that create less-than-optimal EMS systems. A constant search for greater efficiency prompted the development of a computer simulation model to analyze the current EMS system operated by the Tucson Fire Department and to provide statistical information on the effects of potential vehicle base locations on system performance. The simulation model generates data that reflect a variety of parameters necessary in base location analysis. Included in the performance statistics for each unit and for the entire system are indicators of unit use rates, minimum and maximum response times, and proportion of calls reached within the critical response time of eight minutes or less. The model has been carefully validated and used in unit redeployment and unit activation in Tucson, Arizona.

Arizona↗
PubMed1990

Laser Doppler blood flow measurements of common cutaneous donor sites for reconstructive surgery.

The purpose of this study was to evaluate cutaneous blood flow in regions commonly used as donor sites in reconstructive surgery in order to better establish normal flow ranges. Flow was measured with the TSI Laserflo BPM 403 in 27 healthy volunteers and compared to the flow in uncomplicated postoperative autologous tissue transplants. The forehead produced the highest flow, with an average value of 6.50 +/- 0.31 (mean +/- SE), and the dorsalis pedis had the lowest flow, with an average value of 0.60 +/- 0.04. Gender differences were noted in the latissimus dorsi, pectoralis major, and rectus abdominis areas. There were no significant differences between smokers and nonsmokers, hand dominance, musculocutaneous and fasciocutaneous tissues, or supine and sitting body positions. Flow levels in volunteers were similar to those in postoperative surviving autologous tissue transplants. The site-specific flow and flow changes over long time periods (hours) have helped clinical monitoring of 77 patients in the last 24 months. In every case identified by the flowmeter as decreased perfusion, a definite etiology for low reduction was documented. Complications occurred in 12 patients, and the rate of salvaging compromised tissue has increased from 50 percent using temperature monitoring and clinical observation to 83 percent with the computerized laser Doppler flowmeter.

Blood Flow Velocity↗
PubMed1990

MDR1 transcript levels as an indication of resistant disease in acute myelogenous leukaemia.

The expression of the MDR1 gene was studied by Northern blot analysis in leukaemic cell specimens obtained from 74 patients with acute myelogenous leukaemia (AML). No relationship was found between MDR1 RNA levels and FAB type of leukaemia or patient age. Transcript levels tended to be highest in the leukaemic cells of patients with a history of toxic exposure or preleukaemia compared with 'standard risk' patients at diagnosis but the differences were not significant (P = 0.07). Patients whose leukaemic cells contained high MDR1 transcript levels were difficult to induce into remission and, if remission was induced, the remissions were short. Hence high levels of MDR1 expression may explain, at least in part, the ineffectiveness of anthracycline antibiotic containing treatment regimens in some patients with AML.

Adolescent↗
PubMed1990

Multiple system degeneration with glutamate dehydrogenase deficiency: pathology and biochemistry.

The neuropathological findings in a patient with antemortem diagnosis of olivopontocerebellar atrophy (OPCA) and reduced leucocytic glutamate dehydrogenase (GDH) activity included cerebellar cortical degeneration, most marked in the superior vermis, mild atrophy of the pons and the inferior olivary nucleus, marked reduction of anterior horn cells at all levels and gliosis in both lateral columns. GDH activities and their thermolability in "soluble" and "particulate" fractions in the cerebral cortex, cerebellar hemisphere and vermis were not significantly different from the values in two control brains. GDH mRNA in the patient's brain was not altered in size or amount.

Aged↗
PubMed1990

Alcohol consumption and problem drinking in Vietnam era veterans and nonveterans.

The relationship between Vietnam era veteran status and 13 indicators of alcohol consumption and problem drinking is examined using data from the 1977, 1983 and 1985 National Health Interview Surveys conducted by the National Center for Health Statistics. Compared to a group of nonveterans frequency matched on age, a greater proportion of Vietnam era veterans are currently heavy drinkers and a smaller proportion are abstainers, after simultaneous adjustment for seven demographic factors (age, region of the U.S., urbanization, ethnicity, marital status, education and income). Further, both white veterans and white nonveterans demonstrate an effect of increasing abstention with increasing age across the 3 interview years. In all race and veteran groups the proportion of lifetime abstainers can be ranked in increasing order as follows: white veterans, white nonveterans, non-white veterans and non-white nonveterans. This ranking is reversed for lifetime heavy drinking. Nearly half of the white veterans report drinking heavily at some point in their lives. Among both whites and non-whites, a significantly greater proportion of veterans than nonveterans report alcohol-related motor vehicle crashes or violations.

Accidents, Traffic↗
PubMed1990

A twin study of the effects of the Vietnam conflict on alcohol drinking patterns.

This study examines the association between military service in Southeast Asia and alcohol drinking patterns in 2,169 male-male monozygotic twin pairs who both served on active military duty during the Vietnam era (1965-75). Data on alcohol drinking were collected in 1987 by mail and telephone interview. The alcohol drinking measures include three indicators of abstention (lifetime abstainer, lifetime non-regular drinker, and current abstainer) and two indicators of consumption (average daily ethanol consumption and high consumption). In unadjusted and co-twin adjusted analyses, neither service in Southeast Asia nor combat exposure was significantly associated with any measure of abstention. In the co-twin adjusted analysis, there was no association of Southeast Asia service and combat exposure with average daily ethanol consumption. After adjustment for co-twin effects, 4.0 percent of non-Southeast Asia veterans were high consumers compared to 6.7 percent of Southeast Asia veterans who served in high combat. We conclude that prior military service in a war zone has a relatively modest long-term effect on the alcohol drinking patterns of male veterans.

Adult↗
PubMed1990

Hip fracture incidence among the old and very old: a population-based study of 745,435 cases.

Data were obtained from the Health Care Financing Administration and the Department of Veterans Affairs (formerly called Veterans Administration) on all hospital discharges among the elderly population from 1984 through 1987 and combined with census estimates to calculate incidence rates of hip fracture for the elderly population of the United States. Rates for White women were the highest, reaching 35.4 per 1,000 per year among 95 year-olds. Comparably, White men, Black women, and Black men experienced similar age-related increases in risk, although of less magnitude and relatively less rate of change, respectively.

Black or African American↗
PubMed1990

Systems used to study the nature of the leukemic cell and predict treatment outcome in patients with myeloproliferative disorders.

Cell culture techniques have been used to study normal and leukemic hematopoiesis. Investigations provided data on the nature of the clonogenic leukemic cell, its patterns of in vitro growth, role of stimulating factors, and effects of chemotherapeutic agents. Assay systems developed to study leukemic progenitor cells or self-renewal capacity have been useful clinically as predictive indicators of success of remission-induction therapy and have allowed testing of drug sensitivity in vitro. Alternative approaches using short- and long-term suspension cultures have provided systems to evaluate leukemic cells, including nonclonogenic, biochemical, and kinetic events. In vitro systems have been introduced to measure cell cycle events accurately and to identify metabolic mechanisms of drug resistance. The information provided by all of these systems has allowed a more comprehensive and multifocal characterization of the nature of the leukemic process and has better directed our approach to treatment.

Antineoplastic Agents↗
PubMed1989

Use of the day 6 bone marrow to alter remission induction therapy in patients with acute myeloid leukaemia: a leukemia intergroup study.

Patients with acute myeloid leukaemia who fail to show substantial bone marrow cytoreduction by day 6 of induction therapy enter complete remission (CR) less frequently than patients with good bone marrow leukaemic cytoreduction. The objective of the current study was to determine whether an increase in the intensity of therapy on days 8, 9 and 10 ('augmentation' of remission induction therapy) for patients with poor bone marrow cytoreduction detected in the day 6 bone marrow could improve the complete remission rate without increasing the number of toxic deaths. Patients from six centres were entered and treated with standard dose ara-C for 7 or 10 d and an anthracycline for the first 3 d. Patients aged less than 60 years and with greater than 30% bone marrow biopsy cellularity or greater than 10% abnormal cells on the aspirate obtained 6 d after the start of therapy were augmented with cytosine arabinoside 3 g/m2 every 12 h on days 8, 9 and 10. Therapy was augmented in 116 of the 252 patients less than 60 years. There was a highly statistically significant difference between augmented and nonaugmented patients (P less than 0.001) for the per cent biopsy cellularity and per cent abnormal cells in the day 6 marrow. The CR rate for augmented patients was 69% and for nonaugmented patients 60% suggesting that augmentation therapy abrogated the prognostic significance of more extensive residual leukaemia in the day 6 bone marrow. The results suggest that augmentation of remission induction for patients with poor bone marrow cytoreduction detected 6 d after initiation of therapy, may salvage patients who are destined to fail remission induction because of resistant disease without producing excessive toxicity.

Adult↗
PubMed1989

Determining zygosity in the Vietnam Era Twin Registry: an approach using questionnaires.

The Vietnam Era Twin Registry (VETR) is a registry of 7375 American male veteran twin pairs born between 1939 and 1955 who served in the armed forces of the United States between 1964 and 1975. Optimal use of registry data requires the determination of zygosity. Two approaches are available: analysis of blood genetic marker systems and responses of twins to questions about sibling similarity. Zygosity for the VETR was determined using the questionnaire technique supplemented with blood group typing data abstracted from military records. After comparing four alternative zygosity assignment methods, a logistic regression technique which uses discriminating variables based on race was selected. The approach is similar to that described by Magnus et al. (1983) in their study of Norwegian twins, suggesting that questionnaire responses are independent of nationality and reinforcing the reliability of the questionnaire method for zygosity ascertainment.

Adult↗
PubMed1989

Biodegradation rate of embolized protein microspheres in lung, liver and kidney of rats.

The targeting and sustained release characteristics of cytotoxic drug-loaded protein microspheres may prove useful in the therapeutic chemoembolization of solid tumours. Because biodegradation rate of embolized particles will influence rate of incorporated drug release and duration of exposure, this parameter was studied for microspheres (10-30 microns mean diam.) prepared from the proteins albumin and casein, that we have previously used as carriers for doxorubicin. As a measure of microsphere loss in-vivo the radionuclide 125I was chosen because it can be covalently bound to proteins and also homogeneously distributed throughout the matrix. Radiolabelled microspheres were administered to rats both intravenously (lung as target organ, 1.4-2.2 mg/100 g) and via the hepatic artery (liver as target organ, 0.4-0.8 mg/100 g). In both cases it was observed that the casein system biodegraded more slowly than the albumin in-vivo. Thus, time taken for loss of 50% of embolized microspheres from lung was: albumin 2.0 days; casein 3.5 days and from liver:albumin 3.6 days; casein 6.8 days. Microsphere "debris" did not markedly accumulate in other organs. In-vitro experiments showed that microspheres were stable in serum and that albumin microspheres were not innately more sensitive to enzymic digestion than casein. The results may be useful in estimating duration of exposure of target organs to drug-loaded microsphere systems prepared from these proteins.

Animals↗
PubMed1989

Alcohol consumption and problem drinking in white male veterans and nonveterans.

The relation between veteran status and 15 indicators of alcohol consumption and problem drinking is examined using data from the 1977, 1983, and 1985 National Health Interview Surveys conducted by the National Center for Health Statistics. After simultaneous adjustment for age, region of the US, urbanization, ethnicity, marital status, education, and income, a greater proportion of White male veterans than White male nonveterans were heavy drinkers and a smaller proportion were abstainers. This association appeared in all three survey years; further, veterans consistently reported a high daily consumption level (the equivalent of approximately six bottles of beer, five glasses of wine, or four mixed drinks) compared to nonveterans. Among White male veterans, 6.9 percent reported family or marital problems and 13.9 percent reported motor vehicle crashes or violations compared to 4.4 percent and 8.9 percent, respectively, among nonveterans. The same pattern was observed for lifetime prevalences of alcoholism (veterans have nearly two and a half times the lifetime prevalence of nonveterans), cirrhosis of the liver, and unspecified alcohol-related problems.

Accidents, Traffic↗
PubMed1989

Predictors of functional success in telescopic spectacle use by low vision patients.

Telescopic spectacles can theoretically improve function of low vision patients by enlarging retinal images. However, unintended head movement may produce sufficient instability of enlarged retinal images to negate the visual benefit. We investigated this phenomenon as a cause of failure in 38 low vision patients who had previously attempted use of telescopic spectacles. Patients underwent evaluation of the vestibulo-ocular reflex, visual-vestibulo-ocular reflex, head stability in the pitch and yaw axes, and sensitivity of magnified visual acuity to head motion. Although it was impossible to distinguish successful from unsuccessful telescopic spectacle users by means of clinical or historical data, multiple logistic regression analysis was used to derive a useful predictive function based on measurements of sensitivity of magnified vision to head motion, and head instability in the pitch axis. Predictive performance was found to be superior to conventional clinical judgement. These findings support the hypothesis that retinal image stability is important to functional vision, and suggest that head-stabilizing strategies may improve function with telescopic spectacles in certain low vision patients.

Adult↗